[Carotid endarterectomy in the elderly patient. Life table analysis and review of the literature based on 594 consecutive operations].

The significance of age as a prognostic factor was evaluated in patients undergoing carotid artery surgery between 12.8.86 and 31.10.92 in the Department of Vascular Surgery, Erlangen, 594 operations were performed on 546 consecutive patients using somatosensory evoked potentials as routine monitoring. Patients were divided into an older group of 139 (150 operations) with a mean age of 78.2 years and a younger group of 407 (444 operations) with a mean age of 64.4 years. There was no statistical difference in preoperative neurological status and number of risk factors, although there were different distributions of risk factors and concurrent illnesses. Thirty-day mortality rates were 1.7% for younger and 0.7% for older patients, and the incidence of postoperative stroke was 1.7% and 0.7% respectively (not statistically significant). Cumulative 5-year survival was 72.2% and 68.2% respectively. Cardiac diseases were the main cause of death in both groups, mainly fatal cardiac ischemia in younger patients and non-ischemic disease in the older patients. The 5-year stroke-free survival rate was 81% and 91.3% respectively (not significant). There was a trend towards a worse outcome for older patients with stages IIb and IV disease.